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Hjuler TF, Lee D, Ghetti S. Remembering history: Autobiographical memory for the COVID-19 pandemic lockdowns, psychological adjustment, and their relation over time. Child Dev 2024. [PMID: 39139123 DOI: 10.1111/cdev.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
This longitudinal study examined age- and gender-related differences in autobiographical memory about the COVID-19 pandemic lockdowns and whether the content of these memories predicted psychological adjustment over time. A sample of 247 students (Mage = 11.94, range 8-16 years, 51.4% female, 85.4% White) was recruited from public and private schools in Denmark and assessed three times from June 2020 to June 2021. The findings showed that memories weakened over time in detail and emotional valence. Additionally, psychological well-being decreased over time, with adolescent females faring the worst. Critically, memories including higher levels of negative affect and factual information about COVID-19 and the lockdown predicted worse psychological well-being over time, underscoring aspects of autobiographical memory that might help attenuate the negative consequences of the lockdown.
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Affiliation(s)
- Tirill Fjellhaugen Hjuler
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital-Psychiatry, Aarhus N, Denmark
| | - Daniel Lee
- University of California, Riverside, Riverside, California, USA
| | - Simona Ghetti
- Department of Psychology and Center for Mind and Brain, University of California, Davis, Davis, California, USA
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2
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Gangapersad RN, Zhou G, Garcia-Gomez P, Bos J, Hak E, Koch BCP, Schuiling-Veninga CCM, Dierckx B. Comparison of antipsychotic drug use in children and adolescents in the Netherlands before and during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2024; 33:2695-2703. [PMID: 38183460 PMCID: PMC11272724 DOI: 10.1007/s00787-023-02340-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
This study aims to describe the patterns and trends in antipsychotic prescription among Dutch youth before and during the corona virus disease 2019 (COVID-19) pandemic (between 2017 and 2022). The study specifically aims to determine whether there has been an increase or decrease in antipsychotic prescription among this population, and whether there are any differences in prescription patterns among different age and sex groups. The study utilized the IADB database, which is a pharmacy prescription database containing dispensing data from approximately 120 community pharmacies in the Netherlands, to analyze the monthly prevalence and incidence rates of antipsychotic prescription among Dutch youth before and during the pandemic. The study also examined the prescribing patterns of the five most commonly used antipsychotics and conducted an autoregressive integrated moving average (ARIMA) analysis using data prior to the pandemic, to predict the expected prevalence rate during the pandemic. The prescription rate of antipsychotics for Dutch youth was slightly affected by the pandemic, with a monthly prevalence of 4.56 [4.50-4.62] per 1000 youths before COVID-19 pandemic and 4.64 [4.59-4.69] during the pandemic. A significant increase in prevalence was observed among adolescent girls aged 13-19 years. The monthly incidence rate remained stable overall, but rose for adolescent girls aged 13-19 years. Aripiprazole, and Quetiapine had higher monthly prevalence rates during the pandemic, while Risperidone and Pipamperon had lower rates. Similarly, the monthly incidence rates of Aripiprazole and Olanzapine went up, while Risperidone went down. Furthermore, the results from the ARIMA analysis revealed that despite the pandemic, the monthly prevalence rate of antipsychotic prescription was within expectation. The findings of this study suggest that there has been a moderate increase in antipsychotic prescription among Dutch youth during the COVID-19 pandemic, particularly in adolescent females aged 13-19 years. However, the study also suggests that factors beyond the pandemic may be contributing to the rise in antipsychotic prescription in Dutch youth.
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Affiliation(s)
- Ravish N Gangapersad
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Guiling Zhou
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Pilar Garcia-Gomez
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jens Bos
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Eelko Hak
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Birgit C P Koch
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Catharina C M Schuiling-Veninga
- Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTEE), Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
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Weng W, Liu M, Wang S, Li X, Zhang J, Fu Y, Dong C, Li Y. The impact of lockdown on child adjustment: a propensity score matched analysis. BMC Psychol 2024; 12:409. [PMID: 39061084 PMCID: PMC11282655 DOI: 10.1186/s40359-024-01894-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 pandemic has had an inestimable impact worldwide, challenging the daily lives and interactions of children and their families. In 2022, Shanghai implemented a three-month lockdown in response to an acceleration of positive cases during the pandemic period. This restrictive policy provided insight into the impact of the lockdown on children's social adjustment and the role of parent-child conflict during this process. Mothers of preschool-aged children participated in this study and completed the Chinese version of Child-Parent Relationship Scale (CPRS) and the Strengths and Difficulties Questionnaire (SDQ). Using Propensity Score Matching (PSM) method, two matched groups were formed: pre-lockdown group and post-lockdown group, with a total of 574 preschoolers (N = 297 in each group; Mage = 4.36, SD = 0.86) were recruited. The results showed that the lockdown directly impacted children's emotional symptoms. Additionally, the parent-child conflict mediated relationship between the lockdown and children's adjustment. Specifically, parent-child conflict deteriorated children's emotional symptoms, hyperactivity-attention problems, and prosocial behaviors. These findings highlight the significant impact of the severe lockdown on children's social adjustment and the role of parent-child interactions during this period.
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Affiliation(s)
- Wanjuan Weng
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Mowei Liu
- Department of Psychology, Trent University, Peterborough, Canada
| | - Shumin Wang
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Xiaoyun Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Jinghui Zhang
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China
| | - Yuke Fu
- Department of Psychology, Trent University, Peterborough, Canada
| | - Chuanmei Dong
- School of Education, Macquarie University, Sydney, Australia
| | - Yan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, 100 Guilin Road, Xuhui District, Shanghai, China.
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Yuan W, Jiang Z, Liu Y, Chen Z, Chu X, Song Y. Comprehensively Strengthen and Improve Students' Mental Health System in the New Era. China CDC Wkly 2024; 6:719-722. [PMID: 39050018 PMCID: PMC11264052 DOI: 10.46234/ccdcw2024.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/24/2024] [Indexed: 07/27/2024] Open
Affiliation(s)
- Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhuojun Jiang
- Training and Outreach Division, National Center for Mental Health, Beijing, China
| | - Yunfei Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Ziyue Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Xiaohan Chu
- Training and Outreach Division, National Center for Mental Health, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
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Stocker R, Gupta A, Taylor GS, Shaw JA, West DJ. Adapting to compromised routines: Parental perspectives on physical activity and health for children and adolescents with type 1 diabetes in the UK during COVID-19 lockdown. J Pediatr Nurs 2024; 77:e242-e250. [PMID: 38658303 DOI: 10.1016/j.pedn.2024.04.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/10/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To determine how COVID-19 lockdown impacted physical activity (PA) levels, wellbeing, and diabetes management in children (aged 0-17 years) with type 1 diabetes (T1D), from the perspectives of their parent/guardian. DESIGN AND METHODS This qualitative descriptive study is part of a larger, parallel mixed-methods design study, which incorporated a cross-sectional survey and semi-structured one-to-one interviews. Interviewees were recruited from the survey, which was distributed to parents of children/adolescents with T1D in the UK. Interviews explored diabetes management, mental and physical wellbeing, changes in PA levels, sleep quality before/during lockdown, and the effects of lockdown on the individual and their family. The interviews were transcribed and the data were analysed thematically. RESULTS 14 interviews were conducted with parents. Thematic analysis generated a central theme of routine disruption, with four further themes on diabetes management routines, harnessing the opportunities of lockdown, weighing up risk, and variable impact on wellbeing. CONCLUSIONS Maintaining or increasing PA during COVID-19 lockdown was associated with better diabetes management, sleep, and wellbeing for children/adolescents with T1D, despite significant disruption to established routines. Use of technology during the pandemic contributed positively to wellbeing. PRACTICE IMPLICATIONS It is crucial to emphasize the significance of maintaining a well-structured routine when treating patients with type 1 diabetes. A consistent routine, incorporating regular physical exercise and good sleep hygiene, will help with managing overall diabetes control.
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Affiliation(s)
- Rachel Stocker
- School of Biomedical, Nutritional and Sport Sciences, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - Alisha Gupta
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; University Hospital of North Tees, Hardwick Rd, Hardwick, Stockton-On-Tees TS19 8PE, United Kingdom.
| | - Guy S Taylor
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
| | - James A Shaw
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | - Daniel J West
- Population Health Sciences Institute, Faculty of Medical Sciences, Dame Margaret Barbour Building, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4DR, United Kingdom.
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Do VV, Ling PM, Chaffee BW, Nguyen N. Concurrent Use of Tobacco and Cannabis and Internalizing and Externalizing Problems in US Youths. JAMA Netw Open 2024; 7:e2419976. [PMID: 38958977 PMCID: PMC11222996 DOI: 10.1001/jamanetworkopen.2024.19976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/01/2024] [Indexed: 07/04/2024] Open
Abstract
Importance Little is known about whether concurrent use of tobacco and cannabis is associated with higher or lower levels of mental health problems than use of either substance alone among youths. Objective To examine the association between concurrent use of tobacco and cannabis and mental health problems in a national sample of US youths. Design, Setting, and Participants This cross-sectional study analyzed publicly available wave 6 data within the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort study of US youths aged 14 to 17 years, collected from March to November 2021. This analysis used wave 6 single-wave weights to obtain statistically valid estimates for cross-sectional analyses generalizable to the wave 4 cohort sample. Data were analyzed from November 15, 2023, to April 20, 2024. Exposure Past 30-day use of any tobacco and cannabis products was self-reported and categorized into 4 exclusive patterns: concurrent, tobacco only, cannabis only, and nonuse. Main Outcomes and Measures Self-reported past-year internalizing and externalizing mental health problems were measured using the modified version of the Global Appraisal of Individual Needs-Short Screener and separately categorized into 3 levels: low (0-1 symptoms), moderate (2-3 symptoms), and high (≥4 symptoms). Results A total of 5585 youths were included in the study, with a weighted proportion of 51.3% being male and 72.5% aged 15 to 17 years. In terms of race and ethnicity, 1606 youths (25.7%) were Hispanic, 626 (12.7%) were non-Hispanic Black, 2481 (50.5%) were non-Hispanic White, and 555 (11.0%) were non-Hispanic other. The prevalence of concurrent use (3.4% [95% CI, 2.9%-4.0%]) was comparable to tobacco-only use (3.9% [95% CI, 3.2%-4.6%]), but greater than cannabis-only use (2.5% [95% CI, 2.1%-2.9%]). High levels of internalizing and externalizing problems were most common for the concurrent use group (internalizing: 47.4% [95% CI, 39.2%-55.9%]; externalizing: 61.6% [95% CI, 54.1%-68.7%]), followed by the cannabis-only use group (internalizing: 44.8% [95% CI, 35.7%-54.1%]; externalizing: 48.5% [95% CI, 39.1%-57.9%]), the tobacco-only use group (internalizing: 41.4% [95% CI, 33.7%-49.5%]; externalizing: 46.3% [95% CI, 38.3%-54.5%]), and the nonuse group (internalizing: 22.4% [95% CI, 21.1%-23.8%]; externalizing: 30.4% [95% CI, 28.9%-31.9%]). After controlling for covariates in ordinal logistic regression models, concurrent use of tobacco and cannabis was associated with greater odds of reporting higher levels of externalizing problems compared with tobacco-only use (adjusted odds ratio [AOR], 1.83 [95% CI, 1.15-2.91]) and cannabis-only use (AOR, 1.85 [95% CI, 1.11-3.06]). However, there were no statistically significant differences in the odds of internalizing problems between concurrent use and use of tobacco or cannabis alone. Conclusions and Relevance In this cross-sectional study of the PATH Study wave 6 youth data, concurrent use of tobacco and cannabis was linked to higher levels of externalizing mental health problems than use of single substances, indicating a potential need to combine mental health support with tobacco and cannabis cessation interventions for youths.
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Affiliation(s)
- Vuong V. Do
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
| | - Benjamin W. Chaffee
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- School of Dentistry, University of California, San Francisco
| | - Nhung Nguyen
- Center for Tobacco Control Research and Education, Cardiovascular Research Institute, University of California, San Francisco
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
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Thanachoksawang C, Arphorn S, Jarupat Maruo S, Punneng S, Ishimaru T, Bangkadanara G. Psychological Distress Among High School Students in Bangkok Thailand. Health Psychol Res 2024; 12:120045. [PMID: 38915787 PMCID: PMC11196123 DOI: 10.52965/001c.120045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 06/01/2024] [Indexed: 06/26/2024] Open
Abstract
Introduction This study investigated psychological distress among high school students in Thailand.A sample of 8,345 students from thirty-five Bangkok schools voluntarily participated, responding to a questionnaire and undergoing stress assessments. Socio-demographic factors including grade level, school scale, hometown, parental marital status, presence of siblings, gender, health conditions, online classes, and family monthly income were analyzed. Results Of the participants, 1,087 (13.02%) experienced psychological distress. Grade level, school scale, hometown, parental marital status, and siblings' presence showed no significant associations with distress. However, being female or transgender correlated with higher distress levels. Students with health issues and those in online classes also experienced elevated distress. Additionally, a family monthly income below 10,000 Thai Baht was associated with distress. Conclusion This study sheds light on factors contributing to psychological distress in high school students. It highlights the need for tailored support for vulnerable groups within the student population, emphasizing the role of educators, policymakers, and mental health professionals in addressing these challenges.
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Affiliation(s)
- Chatchai Thanachoksawang
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Sara Arphorn
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suchinda Jarupat Maruo
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suwatsa Punneng
- Health Science Programs, Faculty of Science and Technology, Sakon Nakhon Rajabhat University, Sakon Nakhon, Thailand
| | - Tomohiro Ishimaru
- Department of Medical Humanities, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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Zaccagni L, De Luca F, Rinaldo N, Mazzoni G, Mandini S, Gualdi-Russo E. The COVID-19 Experience in Adolescents: Emotional and Behavioral Recall at the End of the Pandemic. Diseases 2024; 12:116. [PMID: 38920548 PMCID: PMC11202612 DOI: 10.3390/diseases12060116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/27/2024] Open
Abstract
The COVID-19 pandemic and the resulting lockdown countermeasure may have significantly affected adolescents' physical and mental health. This study aims to assess adolescents' recollections of this period, also analyzing their current weight status along with factors they traced back to the epidemic phase and their current sports practice. A survey among 233 Italian adolescents aged 12.4 ± 0.9 years was conducted in October 2023. To achieve the research objectives, a new questionnaire was developed: the COVID-19 AdolesceNt/chilDren Lockdown Experience questionnaire (CANDLE). The new questionnaire was employed to gather data on the adolescents' recollections of the lockdown situation they experienced. The stature and weight of participants were measured directly. The results indicated that middle schoolers remember both positive and negative experiences of the lockdown: the change perceived as the most positive was spending more time with family, while social detachment from peers represents the most negative aspect. According to multivariate regression analysis, certain behaviors they assumed during the lockdown, such as comfort food consumption in boys and sleeping disturbances in girls, in addition to their current sports practice, affected their actual Body Mass Index. This study supports the evidence that changes caused by the COVID-19 lockdown affected adolescents' physical and mental health, albeit with sex differences.
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Affiliation(s)
- Luciana Zaccagni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d’Este 32, 44121 Ferrara, Italy; (L.Z.); (N.R.); (G.M.); (S.M.)
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Federica De Luca
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d’Este 32, 44121 Ferrara, Italy; (L.Z.); (N.R.); (G.M.); (S.M.)
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d’Este 32, 44121 Ferrara, Italy; (L.Z.); (N.R.); (G.M.); (S.M.)
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Gianni Mazzoni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d’Este 32, 44121 Ferrara, Italy; (L.Z.); (N.R.); (G.M.); (S.M.)
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Simona Mandini
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d’Este 32, 44121 Ferrara, Italy; (L.Z.); (N.R.); (G.M.); (S.M.)
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Corso Ercole I d’Este 32, 44121 Ferrara, Italy; (L.Z.); (N.R.); (G.M.); (S.M.)
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Ojio Y, Shiozawa T, Gregorio ER, Leynes MC, Hernandez PMR, Estrada CAM, Fuyama T, Kobayashi J, Satake N. An international interdisciplinary approach to developing video educational materials promoting mental health literacy among adolescents in the Philippines. Early Interv Psychiatry 2024. [PMID: 38772864 DOI: 10.1111/eip.13545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 04/18/2024] [Accepted: 05/06/2024] [Indexed: 05/23/2024]
Abstract
AIM Adolescent mental ill-health is a common international challenge affecting both high- and lower-middle-income countries. The Republic of the Philippines enacted its first mental health law in 2019, underlining the importance of the promotion of adolescent mental health education in schools. In Japan, course instructions about mental ill-health were formulated in a Course of Study that reflects governmental curriculum guidelines. Embedded since 2022, the Course of Study aimed to promote an understanding of current issues of adolescent health. The National Center for Global Health and Medicine in Japan has been sharing experience of promoting public health practices and advancing medical technology in low- and middle-income countries, especially in the Western Pacific region. This paper describes the development process and content of these resources by an interdisciplinary team from Japan and the Philippines. METHODS The interdisciplinary team created an embedded mental health education programme using animated videos for the Philippine school curriculum to improve mental health literacy in adolescents. RESULTS Two six-minute animated videos of age-relevant stories were created. The animation scenarios illustrate: 1) mental health problems and recovery; and 2) major symptoms of mental illnesses, including depression, anxiety, and schizophrenia. Each animated video presents several items for discussion among students and/or teachers, both in class and online for students unable to attend school. CONCLUSION Our efforts may provide good opportunities for enhancing adolescents' mental health activities in the Philippines. In the following steps, we should investigate the effectiveness of school-based MHL using these animated videos with rigorous evaluation methods.
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Affiliation(s)
- Yasutaka Ojio
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuma Shiozawa
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Nursing Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Nursing Innovation Research Center (NIReC), Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ernesto R Gregorio
- Department of Health Promotion and Education, College of Public Health, Manila, Philippines
| | - Maria Cynthia Leynes
- Department of Psychiatry and Behavioral Medicine, College of Medicine, Manila, Philippines
| | - Paul Michael R Hernandez
- Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila, Manila, Philippines
| | | | - Taruto Fuyama
- Department of Animation, Graduate School of Film and New Media, Tokyo University of the Arts, Tokyo, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Naoko Satake
- Department of Psychiatry, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
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Wolf K, Schmitz J. Scoping review: longitudinal effects of the COVID-19 pandemic on child and adolescent mental health. Eur Child Adolesc Psychiatry 2024; 33:1257-1312. [PMID: 37081139 PMCID: PMC10119016 DOI: 10.1007/s00787-023-02206-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023]
Abstract
The COVID-19 pandemic and associated containment measures have massively changed the daily lives of billions of children and adolescents worldwide. To investigate the global longitudinal effects on various mental health outcomes over a period of 1.5 years, we conducted a scoping review in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Web of Science, and APA PsycInfo that were published between December 2019 and December 2021, followed a longitudinal or repeated cross-sectional design, and quantitatively assessed with clinical questionnaires the effect of the COVID-19 pandemic or a related stressor on mental health indicators in community samples of children and adolescents.The results of our qualitative analysis of 69 studies indicate a general trend of less psychological well-being and more mental health problems, such as heightened stress, and depressive and anxiety symptoms during the pandemic. Data suggest that both protection measure intensity and infection dynamics were positively associated with severity of the psychopathology. The most reported influencing factors were age, gender, socio-economic status, previous state of mental and physical health, self-regulation abilities, parental mental health, parenting quality, family functioning, social support, isolation and loneliness, health-related worries, and consistent routines and structure. Our results demonstrate that children and adolescents worldwide have experienced more mental health problems due to the COVID-19 pandemic. They call for improved access to child and adolescent mental health care and prioritisation of child and adolescent welfare in political decision making.
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Affiliation(s)
- Kristin Wolf
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany.
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Wilhelm-Wundt-Institute for Psychology, University of Leipzig, Leipzig, Germany
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Hjuler TF, Rask CU, Kallesøe KH. For better or for worse? Memories and mental health related to COVID-19 lockdowns in adolescents with Attention Deficit Disorders. Nord J Psychiatry 2024; 78:255-263. [PMID: 38368509 DOI: 10.1080/08039488.2024.2313563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 01/24/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE In adolescents with Attention Deficit Hyperactivity Disorders (ADHD, ICD-10 defined) we examined self-reported well-being, depressive symptoms and autobiographical memories from the first COVID-19 lockdown in Denmark in comparison to adolescents without an ADHD diagnosis. METHODS Data from 16 adolescents with ADHD and 16 non-ADHD age and gender matched controls were collected between September 2020 and April 2021. Questionnaires included the World Health Organization Well-Being Index (WHO-5), the Short Mood and Feelings Questionnaire (SMFQ), and an autobiographical memory survey assessing a lockdown memory, a memory not related to lockdown and a future projection. Mixed design ANOVAs were used to compare within subject differences in memory types across groups and independent sample t-tests were used to compare group differences. RESULTS Three adolescents with ADHD scored below the WHO-5 cut-off (< 50) and above the SMFQ cut-off (> 8) indicating risk of depression, compared to two in the control group. Both groups rated lockdown memories as less positive and more negative and reported feeling more sad and worried when reminiscing about lockdown experiences compared to 'other personal memories' and 'future projections'. Compared to the non-ADHD controls, adolescents with ADHD reported more sadness, t(30) = -0.2.45, p < .05 and worries t(30) = -3.84, p < .001 when reminiscing about the lockdown. CONCLUSIONS Even though there were no striking differences between groups in the assessments on risk of depression, the findings suggest that adolescents diagnosed with ADHD were more negatively affected when recalling memories about the lockdown compared to their peers.
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Affiliation(s)
- Tirill F Hjuler
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Charlotte U Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Karen H Kallesøe
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
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12
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Lassi N. Extraversion and low introversion more equivalent to high introversion in depression during COVID-19. J Pers 2024. [PMID: 38494629 DOI: 10.1111/jopy.12931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE This study investigated whether forms of extraversion-introversion produced different depression-related outcomes before and during the COVID-19 pandemic. METHOD One-way MANCOVAs were conducted to investigate the relationship between extraversion-introversion and depressive symptoms. These data were sourced from the NLSY97, consisting of 4846 individuals born between 1980 and 1984. RESULTS During pre-pandemic periods, high introversion increased the risk of depressive symptoms. During the pandemic, the risk for depressive symptoms was more equivalent, or less predominately high-introvert-based, among extraverted/low introverted and high introverted subjects. CONCLUSIONS Extraversion/low introversion was linked with increased depression, relative to high introversion, during the pandemic. The findings raise significant questions about how individuals with distinct personality traits may experience changes in their psychological well-being during challenging public health events.
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Affiliation(s)
- Nicholas Lassi
- School of Law, Southwest University of Political Science and Law, Chongqing, China
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13
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Oblath R, Dayal R, Loubeau JK, Lejeune J, Sikov J, Savage M, Posse C, Jain S, Zolli N, Baul TD, Ladino V, Ji C, Kabrt J, Sidky L, Rabin M, Kim DY, Kobayashi I, Murphy JM, Garg A, Spencer AE. Trajectories and correlates of mental health among urban, school-age children during the COVID-19 pandemic: a longitudinal study. Child Adolesc Psychiatry Ment Health 2024; 18:32. [PMID: 38486248 PMCID: PMC10941406 DOI: 10.1186/s13034-024-00712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/25/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic posed numerous obstacles to psychosocial wellbeing for children. We conducted a longitudinal study to evaluate child mental health and social risks during the pandemic. METHODS Participants were 172 caregivers of children aged 6-11 years old who attended well child visits within 6 months before pandemic onset at an urban safety net hospital in the US. Prepandemic data was extracted from the electronic medical record, and surveys were administered at three time points between August 2020 and July 2021. We measured mental health symptoms with the Pediatric Symptom Checklist-17, social risks (e.g., food and housing insecurity) with the THRIVE questionnaire, and school modality (in-person, hybrid, remote). RESULTS Compared to pre-pandemic, children had significantly higher PSC-17 total scores (overall mental health symptoms) and THRIVE total scores (total burden of social risks) at all three mid-pandemic waves. Using longitudinal mixed models accounting for time, social risks, and school modality, both social risks (B = 0.37, SE = 0.14, p < 0.01) and school modality were significantly associated with PSC-17 scores (B = - 1.95, SE = 0.63, p < 0.01). Children attending in-person school had fewer mental health symptoms than those attending remote or hybrid school. CONCLUSION Mental health symptoms and social risks remained significantly higher fifteen months after the onset of the COVID-19 pandemic compared to prepandemic. In-person attendance at school appeared protective against persistently elevated mental health symptoms.
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Affiliation(s)
- Rachel Oblath
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, USA
- BEST Partnership for Behavioral Health, Racial, and Social Justice, Boston, MA, USA
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Rohan Dayal
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- School of Public Health, Boston University, Boston, MA, USA
| | | | - Julia Lejeune
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jennifer Sikov
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychology, College of Arts, Sciences, and Education, Florida International University, FL, Miami, USA
| | - Meera Savage
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Catalina Posse
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Sonal Jain
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nicole Zolli
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Tithi D Baul
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Valeria Ladino
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Chelsea Ji
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Jessica Kabrt
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Lillian Sidky
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Megan Rabin
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Do Yoon Kim
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Imme Kobayashi
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- New York University Grossman School of Medicine, NY, New York City, USA
| | - J Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Arvin Garg
- Department of Pediatrics, Child Health Equity Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
- University of Massachusetts Memorial Children's Medical Center, Worcester, MA, USA
| | - Andrea E Spencer
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA.
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA.
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, IL, Chicago, USA.
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Ouyang JX, Pustilnik S, Cotton A, Fallucco EM, Hopkins M. Building Integrated Mental Health Services in Pediatric Primary Care: User Guide from the Academic Trenches. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024:10.1007/s40596-024-01946-2. [PMID: 38448716 DOI: 10.1007/s40596-024-01946-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/12/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Jessica X Ouyang
- Medstar Georgetown University Hospital, Georgetown University Medical Center, Washington, DC, USA.
| | - Sean Pustilnik
- Medstar Georgetown University Hospital, Georgetown University Medical Center, Washington, DC, USA
| | - Aronica Cotton
- Medstar Georgetown University Hospital, Georgetown University Medical Center, Washington, DC, USA
| | - Elise M Fallucco
- Children's Hospital of the King's Daughters, Eastern Virginia Medical School, Norfolk, VA, USA
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Sayed AA, El-Gendy AA, Aljohani AK, Haddad RA, Taher OH, Senan AM, Qashqari AM, Alqelaiti BA. The Effects of COVID-19 on the Mental Health of Children and Adolescents: A Review. Cureus 2024; 16:e56473. [PMID: 38638779 PMCID: PMC11025694 DOI: 10.7759/cureus.56473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/20/2024] Open
Abstract
The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has profoundly affected global health and well-being. As part of the Coronaviridae family, SARS-CoV-2 joins a diverse group of viruses found in both humans and various animal species, including bats, camels, and cats. The pandemic has led to widespread social isolation, reduced physical activity, and significant lifestyle changes, posing potential risks to individuals' mental and emotional health. This review aims to explore the implications of COVID-19 on the mental health of children and adolescents, given the limited attention this population has received in the medical literature. Multiple research studies in several countries have found that the COVID-19 pandemic is associated with greater stress levels, depression, anxiety, insomnia, drug misuse, and other mental health challenges among young individuals. Understanding the long-term effects of the pandemic on mental health is crucial for developing effective interventions and support systems to promote resilience and well-being in children and adolescents. Even after the pandemic ends, it is crucial to prioritize understanding the long-term impacts of the pandemic on mental health, integrating findings into public health strategies, addressing mental healthcare disparities, and fostering resilience in children and adolescents. Achieving these objectives requires collaborative efforts across various sectors to ensure equitable access to mental health resources and the implementation of sustainable solutions for the well-being of young people in the aftermath of the pandemic.
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Affiliation(s)
- Anwar A Sayed
- Department of Surgery and Cancer, Imperial College London, London, GBR
- College of Medicine, Taibah University, Medina, SAU
| | | | | | | | - Odai H Taher
- College of Medicine, Taibah University, Medina, SAU
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16
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Reiß F, Behn S, Erhart M, Strelow L, Kaman A, Ottová-Jordan V, Bilz L, Moor I, Ravens-Sieberer U. Subjective health and psychosomatic complaints of children and adolescents in Germany: Results of the HBSC study 2009/10 - 2022. JOURNAL OF HEALTH MONITORING 2024; 9:7-22. [PMID: 38559686 PMCID: PMC10977472 DOI: 10.25646/11868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/14/2023] [Indexed: 04/04/2024]
Abstract
Background Subjective health and well-being are important health indicators in childhood and adolescence. This article shows current results and trends over time between 2009/10 and 2022. Methods The Health Behaviour in School-aged Children (HBSC) study examined subjective health, life satisfaction and psychosomatic complaints of N = 21,788 students aged 11 to 15 years in the school years 2009/10, 2013/14, 2017/18 and in the calendar year 2022. Multivariate regression analyses show the associations between sociodemographic characteristics and well-being in 2022, as well as trends since 2009/10. Results The majority of children and adolescents indicate a good subjective health and high life satisfaction. About half of the girls and one third of the boys report multiple psychosomatic health complaints, with a clear increase over time. Older adolescents, girls and gender diverse adolescents are at an increased risk of poor well-being. Subjective health and life satisfaction varied between 2009/10 and 2022, with a significant deterioration between 2017/18 and 2022. Conclusions The high proportion of children and adolescents with psychosomatic complaints, as well as the observed gender and age differences, underline the need for target group-specific prevention, health promotion and continuous health monitoring.
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Affiliation(s)
- Franziska Reiß
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Steven Behn
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Michael Erhart
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
- Alice Salomon University of Applied Sciences Berlin, Health and Rehabilitation Science, Berlin, Germany
| | - Lisa Strelow
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Anne Kaman
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Veronika Ottová-Jordan
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
| | - Ludwig Bilz
- Brandenburg University of Technology Cottbus-Senftenberg, Institute of Health, Cottbus, Germany
| | - Irene Moor
- Martin Luther University Halle-Wittenberg, Medical Faculty, Interdisciplinary Centre for Health Sciences (PZG), Institute of Medical Sociology, Halle (Saale), Germany
| | - Ulrike Ravens-Sieberer
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Section Child Public Health, Hamburg, Germany
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17
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Farokhnia M, Harris JC, Speed SN, Leggio L, Johnson RM. Lifetime use of alcohol and cannabis among U.S. adolescents across age: Exploring differential patterns by sex and race/ethnicity using the 2019 NSDUH data. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 10:100214. [PMID: 38234369 PMCID: PMC10791568 DOI: 10.1016/j.dadr.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/09/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024]
Abstract
Background Early use of alcohol and cannabis is associated with health and social problems. It is unclear how lifetime use changes for each additional year of age during adolescence, and whether this change varies by sex and race/ethnicity. This study characterized lifetime rates of alcohol and cannabis use by age among 12- to 17-year-old American youth and explored differential patterns by sex and race/ethnicity. Methods Data were obtained from the 2019 National Survey on Drug Use and Health. Analyses were restricted to 12-17-year-olds who were non-Hispanic White, non-Hispanic Black, or Hispanic/Latino (n = 11,830). We estimated the increase in lifetime use of alcohol and cannabis by age for the full sample and stratified by sex and race/ethnicity. Slopes of the regression lines were compared to assess differential patterns across groups. Results In these cross-sectional analyses, reported lifetime use increased substantially from age 12 to 17 for alcohol (6.4 % to 53.2 %) and cannabis (1.3 % to 35.9 %). The increase in lifetime alcohol use was slightly, but not significantly, steeper among girls than boys (F1,8 = 3.40, p = 0.09). White and Latino youth showed similar rates of increase in lifetime alcohol use, which was significantly flatter among Black youth (F2,12=21.26, p<0.0001). Latino youth had a slightly, but not significantly, steeper increase in lifetime cannabis use than White and Black youth (F2,12=3.17, p = 0.07). Conclusions Reports of lifetime alcohol and cannabis use substantially increase from age 12 to 17 and the rates are different according to sex and race/ethnicity, highlighting the need for early and tailored substance use prevention in adolescents.
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Affiliation(s)
- Mehdi Farokhnia
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Julia C. Harris
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Shannon N. Speed
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA
| | - Renee M. Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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18
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Ahmedani BK, Yeh HH, Penfold RB, Simon GE, Miller-Matero LR, Akinyemi E, Fallone M, Patel S, Beebani G, Hooker SA, Owen-Smith A, Knowlton G, Levin A, Eke-Usim A, Rossom RC. Psychotherapy Disruption Before and After the Transition to Virtual Mental Health Care Induced by the COVID-19 Pandemic. Psychiatr Serv 2024; 75:108-114. [PMID: 37817579 DOI: 10.1176/appi.ps.20230181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
OBJECTIVE This study aimed to examine population-level disruption in psychotherapy before and after the rapid shift to virtual mental health care induced by the onset of the COVID-19 pandemic in the United States. METHODS This retrospective study used electronic health record and insurance claims data from three U.S. health systems. The sample included 110,089 patients with mental health conditions who were members of the health systems' affiliated health plans and attended at least two psychotherapy visits from June 14, 2019, through December 15, 2020. Data were subdivided into two 9-month periods (before vs. after COVID-19 onset, defined in this study as March 14, 2020). Psychotherapy visits were measured via health records and categorized as in person or virtual. Disruption was defined as a gap of >45 days between visits. RESULTS Visits in the preonset period were almost exclusively in person (97%), whereas over half of visits in the postonset period were virtual (52%). Approximately 35% of psychotherapy visits were followed by a disruption in the preonset period, compared with 18% in the postonset period. Disruption continued to be less common (adjusted OR=0.45) during the postonset period after adjustment for visit, mental health, and sociodemographic factors. The magnitude of the difference in disruption between periods was homogeneous across sociodemographic characteristics but heterogeneous across psychiatric diagnoses. CONCLUSIONS This study found fewer population-level disruptions in psychotherapy receipt after rapid transition to virtual mental health care following COVID-19 onset. These data support the continued availability of virtual psychotherapy.
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Affiliation(s)
- Brian K Ahmedani
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Hsueh-Han Yeh
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Robert B Penfold
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Gregory E Simon
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Lisa R Miller-Matero
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Esther Akinyemi
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Marisa Fallone
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Shivali Patel
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Ganj Beebani
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Stephanie A Hooker
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Ashli Owen-Smith
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Gregory Knowlton
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Albert Levin
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Angela Eke-Usim
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
| | - Rebecca C Rossom
- Center for Health Policy and Health Services Research (Ahmedani, Yeh, Miller-Matero), Behavioral Health Services (Ahmedani, Miller-Matero, Akinyemi, Fallone, Patel, Beebani), and Public Health Sciences (Levin), Henry Ford Health, Detroit; Kaiser Permanente Washington Health Research Institute, Seattle (Penfold, Simon); HealthPartners Institute, Minneapolis (Hooker, Knowlton, Rossom); Center for Research and Evaluation, Kaiser Permanente Georgia, and Department of Health Policy and Behavioral Sciences, Georgia State University, Atlanta (Owen-Smith); Authority Health, Detroit (Eke-Usim)
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19
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Araujo CPD, Piva J, Vettoretti Nicoladeli A, Paniz Hartwig J, Vieira APR, Sica Rocha N, Rocha TS. Lifestyle and quality of life in children and adolescents during the covid-19 social distancing period. J Pediatr (Rio J) 2024; 100:53-59. [PMID: 37591484 PMCID: PMC10751719 DOI: 10.1016/j.jped.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE To evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020. METHODS This cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student's t test, and the generalized estimating equation. RESULTS Mean screen time increased from 2h pre-pandemic to 5h during the pandemic (p < 0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 ± 2.6 to 71.3 ± 13.7, p < 0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 ± 13.3 vs 72.80 ± 13.4 vs 76.4 ± 12.6; p < 0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 ± 13.1 vs 74.5 ± 13.1 vs 76.8 ± 12.2; p < 0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 ± 12.3 vs 72.5 ± 14.4; p < 0.001). Children aged 2-4y old had the best QoLscores. CONCLUSIONS Pandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.
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Affiliation(s)
- Catherine Pires de Araujo
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil.
| | - Jefferson Piva
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil
| | - Amanda Vettoretti Nicoladeli
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil
| | - Jessica Paniz Hartwig
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil
| | - Ana Paula Radunz Vieira
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil
| | - Neusa Sica Rocha
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil
| | - Tais Sica Rocha
- Universidade Federal do Rio Grandes do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Centro de Pesquisa Clínica e Centro de Pesquisa Experimental, Porto Alegre, RS, Brazil
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20
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Gupta M. Mental health effects of the COVID-19 pandemic on children and young adults: empirical analysis of the past, present and the way forward. BJPsych Open 2023; 10:e7. [PMID: 38057143 PMCID: PMC10755555 DOI: 10.1192/bjo.2023.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 12/08/2023] Open
Abstract
The SARS-CoV-2 virus and its variants have had and are having serious implications for the mental health of the public. The critical limitations in the published literature for children, adolescents and young adults raise doubts about their clinical utility and overall generalisability. Amidst these gaps in knowledge, a twin study (Rimfeld et al) addresses several of these issues in relation to heritable individual differences and responses to environmental stressors. Besides calculating genetic correlation, the longitudinal study also compares symptoms at four different time points during the pandemic. These findings reflect a counterintuitive understanding of the role of resilience in the mental health of young adults in the UK. Unlike prior studies, this study focuses on methodological designs and underscores the applications of accurate statistical measures in observing these complex phenomena.
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Affiliation(s)
- Mayank Gupta
- Southwood Psychiatric Hospital, Pittsburgh, Pennsylvania, USA
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21
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Ammerman RT, Mara CA, Anyigbo C, Herbst RB, Reyner A, Rybak TM, McClure JM, Burkhardt MC, Stark LJ, Kahn RS. Behavior Problems in Low-Income Young Children Screened in Pediatric Primary Care. JAMA Pediatr 2023; 177:1306-1313. [PMID: 37843850 PMCID: PMC10580154 DOI: 10.1001/jamapediatrics.2023.4229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/10/2023] [Indexed: 10/17/2023]
Abstract
Importance Screening of behavior problems in young children in pediatric primary care is essential to timely intervention and optimizing trajectories for social-emotional development. Identifying differential behavior problem trajectories provides guidance for tailoring prevention and treatment. Objective To identify trajectories of behavior problems in children 2 to 6 years of age screened in pediatric primary care. Design, Setting, and Participants This retrospective cohort study identified trajectories of behavior problems and demographic and clinical correlates. Data were collected as part of routine care in 3 pediatric primary care offices and 3 school-based health centers in Ohio serving a primarily low-income population. In total, 15 218 children aged 2 to 6 years with well-child visits between July 13, 2016, and January 31, 2022, were included. Exposure Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) at annual well-child visits. Main Outcomes and Measures Trajectory groups were identified using latent growth mixture modeling of SDQ total difficulties scores, and relative risk ratio (RRR) of various demographic (eg, race) and clinical (eg, depression in caregiver) variables were assessed by multinomial logistic regression analysis. Results Of 15 281 children (51.3% males), 10 410 (68.1%) were African American or Black, 299 (2.0%) were Asian, 13 (0.1%) were American Indian or Alaska Native, 876 (5.7%) were multiracial, 26 (0.2%) were Native Hawaiian and Other Pacific Islander, 2829 (18.5%) were White, and 39 (0.02%) were categorized as other. In addition, 944 (6.2%) identified as Hispanic and 14 246 (93.2%) as non-Hispanic. Four behavior problem trajectory groups reflecting severity were identified: low-stable (LS; 10 096 [66.1%]), moderate-decreasing (MD; 16.6%), low-increasing (LI; 13.1%), and high-increasing (HI; 4.3%). Relative to the LS group, patients in each elevated group were more likely to be male (HI RRR, 1.87 [95% CI, 1.55-2.26]; MD RRR, 1.55 [95% CI, 1.41-1.71]; and LI RRR, 1.94 [95% CI, 1.70-2.21]), White (HI RRR, 2.27 [95% CI, 1.83-2.81]; MD RRR, 1.28 [95% CI, 1.13-1.45]; and LI RRR, 1.54, [95% CI, 1.32-1.81]), publicly insured (HI RRR, 0.49 [95% CI, 0.28-0.84]; MD RRR, 0.56 [95% CI, 0.43-0.73]; and LI RRR, 0.50 [95% CI, 0.35-0.73]), have a social need (HI RRR, 3.07 [95% CI, 2.53-3.73]; MD RRR, 2.02 [95% CI, 1.82-2.25]; and LI RRR, 2.12 [95% CI, 1.84-2.44]), and have a caregiver with depression (HI RRR, 1.66 [95% CI, 1.38-2.00]; MD RRR, 1.44 [95% CI, 1.31-1.58]; and LI RRR, 1.39 [95% CI, 1.23-1.58]). Relative to the LI group, patients in the MD group were less likely to be male (RRR, 0.80; 95% CI, 0.68-0.93). Conclusions The substantial portion of young children with increased behavior problems observed in this cohort study underscores the need for screening in pediatric primary care. Caregivers with depression and family social needs warrant prioritization in early prevention and treatment to alter elevated trajectories.
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Affiliation(s)
- Robert T. Ammerman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Constance A. Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Chidiogo Anyigbo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Rachel B. Herbst
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Allison Reyner
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Tiffany M. Rybak
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Jessica M. McClure
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Mary Carol Burkhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Lori J. Stark
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Robert S. Kahn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Michael Fisher Child Health Equity Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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22
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Hirth JM, Gonzalez SJ, Zoorob R. The Social Context: Social and Behavioral Factors That Affect Health Outcomes. Prim Care 2023; 50:601-620. [PMID: 37866834 DOI: 10.1016/j.pop.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
To achieve understanding and best care, screening and treating patients should consider the patient's social environment. Social and behavioral factors influence both positive and negative health behaviors that influence mental and physical health. Primary care providers continually navigate barriers faced by patients and seek solutions that take into consideration social and behavioral factors. The role of the PCP begins with an understanding of common barriers and community resources, then by assessing and responding to the patient's own challenges, and finally by advocating in the clinic and public for changes to the underlying social and structural causes of morbidity and mortality.
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Affiliation(s)
- Jacqueline M Hirth
- Department of Family and Community Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77098, USA.
| | - Sandra J Gonzalez
- Department of Family and Community Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77098, USA
| | - Roger Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77098, USA
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23
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Payne L, Goijen HJ, Cobham V, Bor W, Stathis SS, Coghill DC, Middeldorp CM. The impact of COVID-19 on children and adolescents attending Child and Youth Mental Health Services in Queensland, Australia. Early Interv Psychiatry 2023; 17:1180-1188. [PMID: 37051676 DOI: 10.1111/eip.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/27/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE This explorative study aims to provide insight into impacts of the COVID-19 pandemic and associated restrictions, on mental health of children and adolescents treated at Child and Youth Mental Health Services, and their parents. METHOD The COVID-19 Mental Health Survey was disseminated to parents of children and adolescents under treatment at community Child and Youth Mental Health Services (Brisbane, Australia) between July-November 2020 throughout different stages of COVID-19 related restrictions. Parents of 110 children participated. RESULTS Most reported child's symptoms were sadness (46%), anxiety (60%), lack of focus (61%), lack of joy in their usual activities (38%) and reduction in sleep (42%). Parental emotions were significantly correlated with their child's emotions. Parent's lack of enjoyment of usual activities had the overall strongest average correlation (0.27) but this was no longer significant once other variables were controlled for. Children who attended school remotely for some of the days had a significantly (p < .05) higher risk of having more reported symptoms. Interestingly, in later stages of the lockdown with further easing of restrictions, symptoms also tended to be more severe. CONCLUSION Cross-sectional data on children and adolescents in Queensland, Australia with pre-existing mental health issues suggests mental health continued to deteriorate through the pandemic even as restrictions eased. Changes in schooling seem to be an especially important risk factor.
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Affiliation(s)
- Leanne Payne
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Hedwig J Goijen
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Vanessa Cobham
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Australia
| | - William Bor
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - Stephen S Stathis
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
| | - David C Coghill
- Division of Clinical Science, Murdoch Children's Research Institute, Melbourne, Australia
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
- Division of Neuroscience, University of Dundee, Dundee, UK
- Department of Mental Health, Royal Children's Hospital Melbourne, Parkville, Australia
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, St Lucia, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Australia
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24
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Pampati S, Verlenden JV, Cree RA, Hertz M, Bitsko RH, Spencer P, Moore S, Michael SL, Dittus PJ. Children's mental health during the COVID-19 pandemic: a population-based cohort study in the United States. Ann Epidemiol 2023; 88:7-14. [PMID: 37858782 PMCID: PMC10843774 DOI: 10.1016/j.annepidem.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/30/2023] [Accepted: 10/13/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE Examine children's mental health symptoms, including changes during the COVID-19 pandemic. METHODS The COVID Experiences Surveys, designed to be representative of the U.S. household population, were administered online to parents of children aged 5-12 years (wave 1 (W1), October-November 2020, n = 1561; wave 2 (W2), March-May 2021, n = 1287). We modeled changes in children's symptoms of anxiety, depression, and psychological stress and examined associations between demographic characteristics, COVID-19 related experiences, and protective factors with symptoms across both waves using generalized estimating equations. RESULTS Based on parent-report, children's symptoms of anxiety and depression decreased from W1 to W2 (Δ t-score anxiety = -1.8 [95% confidence intervals (CI): -2.5, -1.0]; Δ t-score depression = -1.0 [CI: -1.7, -0.3]). Psychological stress remained consistent. Across waves, older children and children with an emotional, mental, developmental, behavioral, physical, or medical condition were more likely to have specific poor mental health symptoms. Poor mental health symptoms were more likely among children with several contextual stressors (e.g., economic stress, parental emotional strain) and less likely among children with protective factors (e.g., daily routines, neighborhood cohesion). CONCLUSIONS Establishing programs that support mental health, improving access to mental health services, and fostering collaborations to advance children's mental health is important.
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Affiliation(s)
- Sanjana Pampati
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA.
| | - Jorge V Verlenden
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA
| | - Robyn A Cree
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA
| | - Marci Hertz
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA
| | - Rebecca H Bitsko
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Human Development and Disability, Atlanta, GA
| | - Patricia Spencer
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Shamia Moore
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA; Oak Ridge Institute for Science and Education, Oak Ridge, TN
| | - Shannon L Michael
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Atlanta, GA
| | - Patricia J Dittus
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, Atlanta, GA
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25
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Royuela-Colomer E, Fernández-González L, Orue I, Calvete E. The Association between exposure to COVID-19, internalizing symptoms, and Dispositional Mindfulness in Adolescents: a longitudinal pre- and during-pandemic study. Child Psychiatry Hum Dev 2023; 54:1521-1533. [PMID: 35426548 PMCID: PMC9010714 DOI: 10.1007/s10578-022-01349-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 11/29/2022]
Abstract
This study examined the association between contact with COVID-19 and internalizing symptoms in Spanish adolescents, and the moderation and mediation roles of dispositional mindfulness. Adolescents (N = 383; 58% female; Mage = 15.62, SD = 1.32) completed measures of dispositional mindfulness (MAAS-A) and internalizing symptoms (DASS-21), other stressors different from COVID-19, and contact with COVID-19 twice, in October 2019 and 2020. Three profiles emerged according to their contact with COVID-19: (1) little/no contact, (2) knowing someone close (outside home) who was infected, hospitalized, or died, and (3) being or someone at home being infected and/or hospitalized. Compared to little/no contact, both contact profiles predicted dispositional mindfulness and anxiety; and profile 2 predicted stress. Dispositional mindfulness mediated the association between both contact profiles and depression and stress. This study suggests that contact with COVID-19 predicts increased internalizing symptoms in adolescents, which could be partially explained by the decrease in mindfulness levels.
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Affiliation(s)
- Estíbaliz Royuela-Colomer
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain.
| | - Liria Fernández-González
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Izaskun Orue
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Esther Calvete
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
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26
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McOwat K, Pinto Pereira SM, Nugawela MD, Ladhani SN, Newlands F, Stephenson T, Simmons R, Semple MG, Segal T, Buszewicz M, Heyman I, Chalder T, Ford T, Dalrymple E, Shafran R. The CLoCk study: A retrospective exploration of loneliness in children and young people during the COVID-19 pandemic, in England. PLoS One 2023; 18:e0294165. [PMID: 37988366 PMCID: PMC10662715 DOI: 10.1371/journal.pone.0294165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 10/26/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic children and young people (CYP) were socially restricted during a stage of life crucial to development, potentially putting an already vulnerable population at higher risk of loneliness, social isolation, and poorer wellbeing. The objectives of this study are to conduct an exploratory analysis into loneliness before and during the pandemic, and determine which self-reported factors are associated with loneliness. METHODS AND FINDINGS Participants from The Children with Long COVID (CLoCk) national study were invited to take part via an online survey, with a total of 31,017 participants taking part, 31,016 of which reported on their experience of loneliness. Participants retrospectively answered questions on demographics, lifestyle, physical health and mental health and loneliness before the pandemic and at the time of answering the survey. Before the pandemic 6.5% (2,006/31,016) of participants reported experiencing loneliness "Often/Always" and at the time of survey completion 17.4% (5,395/31,016) reported feeling lonelier. There was an association between meeting the research definition of long COVID and loneliness [3.49 OR, 95%CI 3.28-3.72]. CYP who reported feeling lonelier at the time of the survey than before the pandemic were assigned female at birth, older CYP, those from Black/African/Caribbean/Black British or other ethnicity groups, those that had 3-4 siblings and lived in more deprived areas. CONCLUSIONS We demonstrate associations between multiple factors and experiences of loneliness during the pandemic. There is a need for a multi-faceted integrated approach when developing interventions targeted at loneliness. It is important to follow up the CYP involved at regular intervals to investigate the progression of their experience of loneliness over time.
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Affiliation(s)
- Kelsey McOwat
- Immunisations and Vaccine Preventable Diseases Department, UK Health Security Agency, London, United Kingdom
| | - Snehal M. Pinto Pereira
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - Manjula D. Nugawela
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Shamez N. Ladhani
- Immunisations and Vaccine Preventable Diseases Department, UK Health Security Agency, London, United Kingdom
| | - Fiona Newlands
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Terence Stephenson
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Ruth Simmons
- Immunisations and Vaccine Preventable Diseases Department, UK Health Security Agency, London, United Kingdom
| | - Malcolm G. Semple
- NIHR Health Protection Research Unit for Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences University of Liverpool, Liverpool, United Kingdom
- Respiratory Medicine, Alder Hey Children’s Hospital, Institute in The Park, University of Liverpool, Liverpool, United Kingdom
| | - Terry Segal
- Department of Paediatrics and Adolescence, University College London Hospital, London, United Kingdom
| | - Marta Buszewicz
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Isobel Heyman
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Hershel Smith Building Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Emma Dalrymple
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
| | | | - Roz Shafran
- University College London—Great Ormond Street Institute of Child Health, London, United Kingdom
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27
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Statile AM, Schweer M, Herrmann L, Warniment A, Duncan M, Demeritt B, Keehn K, Daraiseh NM, Edwards R, Whitesell K, Lin L, Brown D, Muth A, Sorensen R, Hill A, Simmons JM. Implementation of a Children's Hospital Acute Care Behavior Response Team. Pediatrics 2023; 152:e2022059112. [PMID: 37823246 DOI: 10.1542/peds.2022-059112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Pediatric patients with behavioral needs are frequently admitted to the hospital for medical care; when behavioral crises occur, patients and staff are at risk for injury. Our aim was to implement a behavior response team (BRT) to increase the days between employee injury due to aggressive patient interactions on the inpatient medical units from 99 to 150 over 1 year. METHODS A multidisciplinary team used quality improvement methods to design and implement the BRT system that includes 2 options: huddle to proactively plan for patients exhibiting early signs of escalation and STAT for immediate help for patients with imminent risk of harm to self or others. Using run and statistical process control charts, we tracked events per month, days between Occupational Safety & Health Administration-recordable events, and violent restraint use over time for 1 year after implementation. Staff pre and postimplementation surveys were compared to assess staff perception of safety and support provided by the BRT intervention. RESULTS The BRT was implemented across the inpatient system in July 2020, with an average number of 13 events per month. Days between Occupational Safety & Health Administration-recordable events remained stable with a maximum of 134 days. Restraint use remained stable at 0.74 per 1000 patient days. The perception of behavioral support available to staff increased significantly pre to postsurvey. CONCLUSIONS The implementation of a BRT can improve staff perception of support and confidence in safely caring for patients with behavior needs on the inpatient medical unit, although additional provider- and system-level improvements are needed to prevent employee injuries.
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Affiliation(s)
- Angela M Statile
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Hospital Medicine
- James M. Anderson Center for Health Systems Excellence
| | | | - Lisa Herrmann
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Hospital Medicine
| | - Amanda Warniment
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Hospital Medicine
| | | | | | | | - Nancy M Daraiseh
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- James M. Anderson Center for Health Systems Excellence
- Department of Biostatistics and Epidemiology
| | | | | | - Li Lin
- Department of Patient Services
| | | | - Alison Muth
- James M. Anderson Center for Health Systems Excellence
| | - Rena Sorensen
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Jeffrey M Simmons
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
- Division of Hospital Medicine
- James M. Anderson Center for Health Systems Excellence
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Wu P, Wang S, Zhao X, Fang J, Tao F, Su P, Wan Y, Sun Y. Immediate and longer-term changes in mental health of children with parent-child separation experiences during the COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2023; 17:113. [PMID: 37794411 PMCID: PMC10552287 DOI: 10.1186/s13034-023-00659-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND The psychological impact of the COVID-19 pandemic has been understudied among vulnerable populations. This study aimed to examine the immediate and longer-term changes in the mental health of children with parent-child separation experiences during the COVID-19 pandemic, and identify potential buffering opportunities for mental health. METHODS This longitudinal cohort study used data from 723 rural Chinese children who provided data before (Oct. 2019) the COVID-19 pandemic and during the following 2 years. Changes in the probability of depressive symptoms, anxiety symptoms, non-suicide self-injurious (NSSI), suicidal ideation, suicide plan, and suicide attempt were tested across four waves using generalized estimating models (GEE). RESULTS Compared with children who never experienced parent-child separation, children persistently separated from parents since birth experienced greater deterioration in all mental health in the 2-year follow-up (average change: depressive symptoms: β = 0.59, 95% CI [0.26, 0.93]; anxiety symptoms: β = 0.45, 95% CI [0.10, 0.81]; NSSI: β = 0.66, 95% CI [0.31, 1.01]; suicide ideation: β = 0.67, 95% CI [0.38, 0.96]; suicide plan: β = 0.77, 95% CI [0.38, 1.15]; suicide attempt: β = 1.12, 95% CI [0.63, 1.62]). However, children with childhood separation from their parents but reunited with them during the transition to adolescence showed similar even lower changes to counterparts who never experienced parent-child separation (all ps > 0.05). CONCLUSION These results indicating improvements in supportiveness of the caregiving environment during the transition to adolescence may provide the opportunity to buffer the adverse impact of COVID-19 on mental health. Translating such knowledge to inform intervention and prevention strategies for youths exposed to adversity is a critical goal for the field.
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Affiliation(s)
- Peipei Wu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
| | - Shihong Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
| | - Xudong Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
| | - Jiao Fang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China
| | - Puyu Su
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, 81th Meishan Road, Box 230032, Hefei, Anhui Province, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui Province, China.
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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Yuan W, Chen L, Wu Y, Su B, Liu J, Zhang Y, Chen M, Ma Y, Guo T, Wang X, Ma T, Ma Q, Cui M, Ma J, Dong Y. Sleep time and quality associated with depression and social anxiety among children and adolescents aged 6-18 years, stratified by body composition. J Affect Disord 2023; 338:321-328. [PMID: 37343629 DOI: 10.1016/j.jad.2023.06.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/27/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Sleep has been suggested as risk factors for depression and social anxiety in children and adolescents, but little is known about the role of individual body composition on these association. METHOD We conducted a cross-sectional survey of children and adolescents aged 6-18 years in Beijing, China, in 2020, and assessed body composition by using iDXA dual-energy X-ray bone densitometer. Generalized liner model (GLM) and restricted cubic spline (RCS) were employed to analyze the associations between sleep and depression and social anxiety with different body composition. The attributable fraction (AFs) to assess the benefits of improvements of sleep in reducing depression and social anxiety odds. RESULTS Depression and social anxiety accounted for 13.1 % and 30.3 % of the study population. Sleep time was significantly associated with depression (HR = 2.35[1.58, 3.50]), and social anxiety (HR = 1.65[1.24, 2.20]); and sleep quality was significantly associated with depression (HR = 7.27[4.87, 10.84]), and social anxiety (HR = 2.54 [1.99, 3.25]) among children and adolescents. The exposure to both insufficient sleep time and poor sleep quality were associated with a higher odd of depression and social anxiety, but lower BF%, higher muscle rate and FFM/FM alleviated the adverse effects of sleep quality on depression and social anxiety. LIMITATIONS Conclusions about causality remain speculative because of the cross-sectional design. CONCLUSION Insufficient sleep time, poor sleep quality, high BF%, low muscle rate and FFM/FM can jointly associate with anxiety and depression. This study provides new evidence support for accurate prevention and control of mental diseases in children and adolescents with different body types.
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Affiliation(s)
- Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yu Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Tongjun Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Xinxin Wang
- School of Public Health and Management, Ningxia Medical University, Key Laboratory of Environmental Factors and Chronic Disease Control, No.1160, Shengli Street, Xingqing District 750004, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Mengjie Cui
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
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Samuels A, Avital-Magen A, Schusheim G. The Effects of the First Phase of the Covid-19 Pandemic on the Mental Health of Children and Adolescents With preexisting Psychiatric Conditions. Clin Pediatr (Phila) 2023; 62:1008-1017. [PMID: 36726020 PMCID: PMC9899673 DOI: 10.1177/00099228221150157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Few studies have examined the impact of the initial school closures and stay-at-home orders on those vulnerable children and adolescents with preexisting psychiatric conditions. In our study, we explore the impact on this population and identify risk and resilience factors by looking both at those children who were impacted negatively as well as those who were impacted positively by this period. Questionnaires were administered by child and adolescent psychiatrists to 101 parents of child and adolescent outpatients in a mental health clinic as well as 75 of the adolescents, themselves, during the initial stay-at-home orders in Israel. Parents and their children were asked how the situation changed the symptoms for which the children are being treated at our clinic. Information regarding demographic, family, and individual factors was also gathered. The largest group of parents (44%) reported improvement in their child's symptoms during this period, whereas 33% reported no change and 25% reported worsening. Risk factors included parental stress and level of child preoccupation with Covid-19. The major protective factor was parental presence. Although home confinement during the Covid-19 pandemic can lead to worsening mental health status among children, it can also provide an opportunity for those with previous mental health conditions to improve and strive. For these children to improve during such a period, decreased social and academic demands and increased parental presence seem to be key factors. For those who deteriorate, identifying and targeting parental stress can be as important as targeting the child's stress during such times.
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Affiliation(s)
- Ayol Samuels
- Department of Psychiatry, Emek Medical
Center, Afula, Israel
- Department of Psychiatry and Behavioral
Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Guy Schusheim
- Department of Psychiatry, Emek Medical
Center, Afula, Israel
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32
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Elia J, Pajer K, Prasad R, Pumariega A, Maltenfort M, Utidjian L, Shenkman E, Kelleher K, Rao S, Margolis PA, Christakis DA, Hardan AY, Ballard R, Forrest CB. Electronic health records identify timely trends in childhood mental health conditions. Child Adolesc Psychiatry Ment Health 2023; 17:107. [PMID: 37710303 PMCID: PMC10503059 DOI: 10.1186/s13034-023-00650-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/20/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Electronic health records (EHRs) data provide an opportunity to collect patient information rapidly, efficiently and at scale. National collaborative research networks, such as PEDSnet, aggregate EHRs data across institutions, enabling rapid identification of pediatric disease cohorts and generating new knowledge for medical conditions. To date, aggregation of EHR data has had limited applications in advancing our understanding of mental health (MH) conditions, in part due to the limited research in clinical informatics, necessary for the translation of EHR data to child mental health research. METHODS In this cohort study, a comprehensive EHR-based typology was developed by an interdisciplinary team, with expertise in informatics and child and adolescent psychiatry, to query aggregated, standardized EHR data for the full spectrum of MH conditions (disorders/symptoms and exposure to adverse childhood experiences (ACEs), across 13 years (2010-2023), from 9 PEDSnet centers. Patients with and without MH disorders/symptoms (without ACEs), were compared by age, gender, race/ethnicity, insurance, and chronic physical conditions. Patients with ACEs alone were compared with those that also had MH disorders/symptoms. Prevalence estimates for patients with 1+ disorder/symptoms and for specific disorders/symptoms and exposure to ACEs were calculated, as well as risk for developing MH disorder/symptoms. RESULTS The EHR study data set included 7,852,081 patients < 21 years of age, of which 52.1% were male. Of this group, 1,552,726 (19.8%), without exposure to ACEs, had a lifetime MH disorders/symptoms, 56.5% being male. Annual prevalence estimates of MH disorders/symptoms (without exposure to ACEs) rose from 10.6% to 2010 to 15.1% in 2023, a 44% relative increase, peaking to 15.4% in 2019, prior to the Covid-19 pandemic. MH categories with the largest increases between 2010 and 2023 were exposure to ACEs (1.7, 95% CI 1.6-1.8), anxiety disorders (2.8, 95% CI 2.8-2.9), eating/feeding disorders (2.1, 95% CI 2.1-2.2), gender dysphoria/sexual dysfunction (43.6, 95% CI 35.8-53.0), and intentional self-harm/suicidality (3.3, 95% CI 3.2-3.5). White youths had the highest rates in most categories, except for disruptive behavior disorders, elimination disorders, psychotic disorders, and standalone symptoms which Black youths had higher rates. Median age of detection was 8.1 years (IQR 3.5-13.5) with all standalone symptoms recorded earlier than the corresponding MH disorder categories. CONCLUSIONS These results support EHRs' capability in capturing the full spectrum of MH disorders/symptoms and exposure to ACEs, identifying the proportion of patients and groups at risk, and detecting trends throughout a 13-year period that included the Covid-19 pandemic. Standardized EHR data, which capture MH conditions is critical for health systems to examine past and current trends for future surveillance. Our publicly available EHR-mental health typology codes can be used in other studies to further advance research in this area.
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Affiliation(s)
- Josephine Elia
- Department of Pediatrics, Nemours Children's Health Delaware, Sydney Kimmel School of Medicine, Philadelphia, PA, US.
| | - Kathleen Pajer
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Raghuram Prasad
- Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, PA, US
| | - Andres Pumariega
- Department of Psychiatry, University of Florida College of Medicine, University of Florida Health, Gainesville, FL, US
| | - Mitchell Maltenfort
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, US
| | - Levon Utidjian
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
| | - Elizabeth Shenkman
- Department of Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, US
| | - Kelly Kelleher
- The Research Institute, Nationwide Children's Hospital, Department of Pediatrics, The Ohio State University College of Medicine, Ohio, US
| | - Suchitra Rao
- Department of Pediatrics, Children's Hospital of Colorado, University of Colorado, Aurora, CO, US
| | - Peter A Margolis
- James Anderson Center for Health Systems Excellence, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, US
| | - Dimitri A Christakis
- Center for Child Health, Behavior and Development, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, US
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, US
| | - Rachel Ballard
- Department of Psychiatry and Behavioral Sciences and Pediatrics, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, US
| | - Christopher B Forrest
- Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, US
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Department of Healthcare Management, Perelman School of Medicine, the University of Pennsylvania, Philadelphia, US
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Barbieri V, Piccoliori G, Mahlknecht A, Plagg B, Ausserhofer D, Engl A, Wiedermann CJ. Adolescent Mental Health during the COVID-19 Pandemic: The Interplay of Age, Gender, and Mental Health Outcomes in Two Consecutive Cross-Sectional Surveys in Northern Italy. Behav Sci (Basel) 2023; 13:643. [PMID: 37622783 PMCID: PMC10451173 DOI: 10.3390/bs13080643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the mental health and well-being of adolescents. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health among adolescents in Northern Italy by comparing cross-sectional surveys conducted in 2021 and 2022, with a particular focus on the influence of age and gender. The sample included adolescents aged 11-19 years from public schools in South Tyrol. Validated psychometric instruments were used to assess HRQoL, anxiety and depression symptoms, and psychosomatic complaints. Sociodemographic variables, COVID-19 burden, and pandemic-related factors were measured. Statistical analyses included chi-square tests, correlation coefficients, and logistic regression analyses. The results indicated that while the self-reported burden of adolescents decreased significantly in 2022 (n = 1885) compared to 2021 (n = 1760), there were no significant differences in symptoms of anxiety, depressive symptoms, low HRQoL, and increased psychosomatic complaints between the two surveys for both early and late adolescents. Females consistently had higher percentages for all outcome variables, and symptoms of anxiety increased with age in females, but not in males. Both genders experienced an increase in depressive symptoms and low HRQoL with age. The co-occurrence of mental health outcomes was observed, suggesting overlapping patterns among anxiety, depression, low HRQoL, and psychosomatic complaints. These findings underscore the intricate relationship between age, gender, and mental health outcomes among adolescents during the pandemic. It is important to recognize that late adolescents may exhibit distinct vulnerabilities and may require tailored support approaches to address their specific mental health challenges, differing from those needed for early adolescents.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
- Faculty of Education, Free University of Bolzano, 39100 Bolzano, Italy
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy (A.E.)
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology—Tyrol, 6060 Hall, Austria
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34
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Riccardi JS. Exploring the Caregiver-Reported Impact of the COVID-19 Pandemic on Children with Traumatic Brain Injury. Semin Speech Lang 2023; 44:205-216. [PMID: 37327911 DOI: 10.1055/s-0043-1770346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic is expected to have a persistent, negative, and disproportionate impact on children with disabilities. Children with traumatic brain injury (TBI) may be expected to experience a disproportionate impact given the deficits often associated with childhood TBI (e.g., family functioning, fatigue, executive functioning, quality of life). This study aimed to explore the impact of the COVID-19 pandemic on children with TBI and their families, compared to typically developing (TD) children and their families. Thirty caregivers (TBI = 15; TD = 15) completed a series of electronic survey measures. Overall, caregivers reported no negative impact of the COVID-19 pandemic on their family's or child's functioning and association with demographic factors and domains of functioning showed no clear patterns. The findings of this exploratory study support continued longitudinal investigation with larger sample sizes of the provision of supports for all families and children in light of the COVID-19 pandemic. Additional research is needed to understand the effectiveness of targeted services for students with TBI in domains of functioning that are significantly poorer than TD children (e.g., quality of life, executive functioning, fatigue).
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Knapp AA, Hersch E, Wijaya C, Herrera MA, Kruzan KP, Carroll AJ, Lee S, Baker A, Gray A, Harris V, Simmons R, Kour Sodhi D, Hannah N, Reddy M, Karnik NS, Smith JD, Brown CH, Mohr DC. "The library is so much more than books": considerations for the design and implementation of teen digital mental health services in public libraries. Front Digit Health 2023; 5:1183319. [PMID: 37560198 PMCID: PMC10409481 DOI: 10.3389/fdgth.2023.1183319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
Background Adolescence is a vulnerable developmental period, characterized by high rates of mental health concerns, yet few adolescents receive treatment. Public libraries support adolescents by providing them with access to teen programming, technological resources, and have recently been providing mental health services. Digital mental health (DMH) services may help libraries provide scalable mental health solutions for their adolescent patrons and could be well positioned to address the mental health needs of historically underrepresented racial and ethnic (HURE) adolescents; however, little research has been conducted on the compatibility of DMH services with adolescent patron mental health needs or resource needs of library workers supporting them. Methods The research team formed a partnership with a public library, which serves a large HURE adolescent population. We conducted needs assessment and implementation readiness interviews with 17 library workers, including leadership, librarians, and workers with specialized areas of practice. Interview questions focused on library infrastructure, as well as library needs and preferences around the design and implementation of DMH services for adolescents. We used the Consolidated Framework for Implementation Research as guiding implementation determinant framework to code and analyze the interview transcripts. Results Our findings revealed library workers play an important role in guiding patrons to desired resources and share a goal of implementing adolescent DMH resources into the library and elevating marginalized adolescents' voices. Existing library resources, such as the library's role as a safe space for adolescents in the community, close relationships with external and community organizations, and availability of no-cost technological resources, could help facilitate the implementation of DMH services. Barriers related to community buy-in, mental health stigma, and library worker confidence in supporting adolescent mental health could affect service implementation. Conclusions Our findings suggest public libraries are highly promising settings to deploy DMH services for adolescents. We identified important determinants that may impact the implementation of DMH services in public library settings. Special considerations are needed to design services to meet the mental health needs of HURE adolescent populations and those adolescents' most experiencing health inequities.
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Affiliation(s)
- Ashley A. Knapp
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Emily Hersch
- Department of Psychology, University of Massachusetts Boston, Boston, MA, United States
| | - Clarisa Wijaya
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Miguel A. Herrera
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kaylee P. Kruzan
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Allison J. Carroll
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Sydney Lee
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Alex Baker
- Department of Psychology, The University of North Texas, Denton, TX, United States
| | - Alanna Gray
- Oak Park Public Library, Oak Park, IL, United States
| | - Vann Harris
- Oak Park Public Library, Oak Park, IL, United States
| | | | - Deepika Kour Sodhi
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Nanette Hannah
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Madhu Reddy
- Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, United States
| | - Niranjan S. Karnik
- College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Justin D. Smith
- School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - C. Hendricks Brown
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David C. Mohr
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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36
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Yoon SY, Kim HM, Yi YY. The impact of the COVID-19 pandemic era on children with primary headache: a questionnaire survey study and literature review. Front Pediatr 2023; 11:1179979. [PMID: 37492607 PMCID: PMC10364439 DOI: 10.3389/fped.2023.1179979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic has resulted in individual isolation and secondary problems, especially in children. Research on the effect of the social isolation on children with primary headache is limited. This study aimed at exploring the effects of environmental changes caused by COVID-19 on headache in children. Methods This cross-sectional survey study enrolled school-aged children (age, 8-16 years) with headache who were able to complete the questionnaire from a Pediatric Headache Clinic between January 2021 and December 2022. Headache diaries for all patients were in their medical records and two questionnaire responses were requested at a 3-month interval. The questionnaires included headache type, frequency, previous medical conditions, family history, Pediatric Migraine Disability Assessment scores (PedMIDAS) scores, changes in daily life after COVID-19, and factors that aggravated headaches associated with social distancing. Results We identified 35 patients who were diagnosed with primary headache and continued to visit our outpatient clinic for at least 3 months. Among them, 33 (15 males and 18 females) patients responded to the first survey. The average age (±SD) of patients was 12.5 ± 1.9 years. PedMIDAS scores were not affected by the COVID-19 infection history. Prolonged use of masks and increased use of digital devices were reported as the most common factors that aggravated headache during the pandemic era. Conclusion COVID-19 did not affect in worsening primary headache in children. However, the pandemic can introduce various changes in daily life, which in turn can affect the management of headache. By gathering feedback regarding the thoughts of the patients on the impact of the current pandemic environment, patient counseling on the precautions and management can be conducted in advance in the case of repeated lockdown in the future.
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Affiliation(s)
- So Yeon Yoon
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Hye Min Kim
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Yoon Young Yi
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
- Department of Pediatrics, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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Xing J, Xu X, Li X, Luo Q. Psychological Resilience Interventions for Adolescents during the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:543. [PMID: 37503990 PMCID: PMC10376838 DOI: 10.3390/bs13070543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/18/2023] [Accepted: 06/25/2023] [Indexed: 07/29/2023] Open
Abstract
The COVID-19 pandemic has had severe mental health effects on adolescents. Psychological resilience is the ability to recover quickly from adversity and can help adolescents cope with the stress and dangers brought by the pandemic better. Therefore, the current study aimed to explore the developmental pattern of psychological resilience in adolescents and to find the sensitive period for psychological resilience intervention to promote resilience in adolescents during the pandemic. The study measured the psychological resilience of a total of 559 adolescents using the Connor-Davidson resilience scale (CD-RISC) in four grades: grade 7 and grade 8 in a junior high school, and grade 10 and grade 11 in a high school. It was found that the resilience level of the adolescents decreased in grade 10 and then increased significantly in grade 11 (F = 4.22, p = 0.006). A 4-week resilience intervention was conducted in the four grades using both psychological course training and physical training. The results revealed that the psychological course training was effective in promoting resilience in the 7th (F = 4.79, p = 0.03) and 8th (F = 4.75, p = 0.03) grades, but not in the 10th and 11th grades. The result suggests that the 7th and 8th grades may be a critical period for psychological resilience interventions for adolescents.
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Affiliation(s)
- Jingwen Xing
- School of Primary Education, Shanghai Normal University Tianhua College, Shanghai 201815, China
| | - Xiaofeng Xu
- School of Health, Shanghai Normal University Tianhua College, Shanghai 201815, China
| | - Xing Li
- School of Psychology, Central China Normal University, Wuhan 430079, China
| | - Qing Luo
- School of Public Policy and Administration, Nanchang University, Nanchang 330031, China
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Challa C, Geng-Ramos G, Gray L, Orshan T, Thackeray L, Gupta P. Anxiety in children: A review on how to address it in the perioperative setting post-pandemic. Paediatr Anaesth 2023; 33:422-426. [PMID: 36876996 DOI: 10.1111/pan.14656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 01/22/2023] [Accepted: 02/18/2023] [Indexed: 03/07/2023]
Abstract
In this paper, we review the psychological burden of SARS-CoV-2 on children and how health care workers can play a role in mitigating its mental health impact during anesthetic procedures. We evaluate the societal changes that have affected children over 2 years of the pandemic and the subsequent soaring rates of anxiety and depression reported. Unfortunately, the perioperative setting is a stressful experience at baseline and the addition of COVID-19 has only exacerbated the situation. Anxiety and depression are often linked to maladaptive behavior post-surgery, including increased rates of emergence delirium. Providers can utilize techniques based on developmental milestones, Certified Child Life Specialists, parental presence during induction, and medications to reduce anxiety. As health care workers, we need to recognize and address these concerns as untreated mental health issues can leave long-term consequences for children.
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Affiliation(s)
- Chaitanya Challa
- Children's National Hospital Ringgold Standard Institution - Anesthesiology, Pain & Preoperative Medicine, Washington, District of Columbia, USA
| | - Giuliana Geng-Ramos
- Children's National Hospital Ringgold Standard Institution - Anesthesiology, Pain & Preoperative Medicine, Washington, District of Columbia, USA
| | - Laura Gray
- Children's National Hospital Ringgold Standard Institution - Anesthesiology, Pain & Preoperative Medicine, Washington, District of Columbia, USA
| | - Taytum Orshan
- Children's National Hospital Ringgold Standard Institution - Anesthesiology, Pain & Preoperative Medicine, Washington, District of Columbia, USA
| | - Laura Thackeray
- Children's National Hospital Ringgold Standard Institution - Anesthesiology, Pain & Preoperative Medicine, Washington, District of Columbia, USA
| | - Pooja Gupta
- Children's National Hospital Ringgold Standard Institution - Anesthesiology, Pain & Preoperative Medicine, Washington, District of Columbia, USA
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39
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Nagata JM, Yang J, Alsamman S, Al-Shoaibi AAA, Ganson KT, Pettee Gabriel K, Baker FC. Higher blood pressure and weight observed among early adolescents during the COVID-19 pandemic. Am J Prev Cardiol 2023; 14:100508. [PMID: 37313357 PMCID: PMC10198794 DOI: 10.1016/j.ajpc.2023.100508] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/29/2023] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
The COVID-19 pandemic led to significant disruptions in the lifestyle behaviors of adolescents; however, there is a paucity of data on objective changes in health indicators of adolescents such as blood pressure, hypertension, and weight. The aim of this study is to quantify differences in blood pressure and weight before and during the COVID-19 pandemic among a demographically diverse national sample of early adolescents. We analyzed cross-sectional data from 2018 to 2020, corresponding to the second follow-up year (Year 2) of the Adolescent Brain Cognitive Development (ABCD) Study. Among 4,065 early adolescents (mean age 12.00, 49.4% female, 55.5% white), 3.4% vs 6.4% of adolescents had hypertension pre-pandemic vs during the pandemic (p < 0.001). The pandemic was associated with a 4.65 percentile (95% CI 2.65, 6.66) higher diastolic blood pressure, and a 1.68 kg (95% CI 0.51, 2.85) higher weight when adjusting for covariates. The pandemic was associated with a 1.97 higher odds of hypertension (95% CI 1.33, 2.92) compared to pre-pandemic when adjusting for covariates. Future studies should explore mechanisms and longitudinal trends in blood pressure among adolescents as they return to pre-pandemic lifestyle behaviors.
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Affiliation(s)
| | - Joanne Yang
- University of California, San Francisco, United States
| | - Sana Alsamman
- University of California, San Francisco, United States
| | | | | | | | - Fiona C Baker
- SRI International, United States
- University of the Witwatersrand, South Africa
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40
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Barbieri V, Wiedermann CJ, Piccoliori G, Mahlknecht A, Plagg B, Ausserhofer D, Ravens-Sieberer U, Engl A. Evolution of Youth's Mental Health and Quality of Life during the COVID-19 Pandemic in South Tyrol, Italy: Comparison of Two Representative Surveys. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050895. [PMID: 37238443 DOI: 10.3390/children10050895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has led to an increase in youth mental health problems worldwide. Studies have revealed substantial variation in the incidence of these problems across different regions. Longitudinal studies of children and adolescents in Italy are lacking. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health in Northern Italy by comparing surveys conducted in June 2021 and in March 2022. METHODS A representative, large cross-sectional, online survey investigated HRQoL, psychosomatic complaints, and symptoms of anxiety and depression among 5159 and 6675 children and adolescents in 2021 and 2022, respectively, using the KIDSCREEN-10 index, HBSC symptom checklist, SCARED, CES-DC, and PHQ-2 instruments. Statistical analyses included a multivariate linear regression analysis. RESULTS Baseline characteristics showed significant differences in demographic variables between the two surveys. Girls and their parents reported a significantly lower HRQoL in 2021 than in 2022. Psychosomatic complaints differed significantly between sexes, and the results showed no decrease in psychosomatic complaints, anxiety, or depression between 2021 and 2022. Predictors of HRQoL, anxiety, depressive symptoms, and psychosomatic complaints in 2022 differed from those in 2021. CONCLUSIONS The characteristics of the 2021 pandemic, including lockdowns and home schooling, may have contributed to the differences between the two surveys. As most pandemic restrictions ended in 2022, the results confirm the need for measures to improve the mental and physical health of children and adolescents after the pandemic.
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Affiliation(s)
- Verena Barbieri
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Christian J Wiedermann
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
- Department of Public Health, Medical Decision Making and Health Technology Assessment, University of Health Sciences, Medical Informatics and Technology, 6060 Hall, Austria
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Barbara Plagg
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
- Faculty of Education, Free University of Bolzano, 39100 Bolzano, Italy
| | - Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana College of Health Professions, 39100 Bolzano, Italy
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Boboc AA, Novac CN, Marin AG, Ieșanu MI, Plătică C, Buzescu T, Coșoreanu MT, Galoș F. SARS-CoV-2 Positive Serology and Islet Autoantibodies in Newly Diagnosed Pediatric Cases of Type 1 Diabetes Mellitus: A Single-Center Cohort Study. Int J Mol Sci 2023; 24:ijms24108885. [PMID: 37240231 DOI: 10.3390/ijms24108885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, although presenting less severe forms of the disease in children, seems to play a role in the development of other conditions, including type 1 diabetes mellitus (T1DM). After the beginning of the pandemic, an increase in the number of T1DM pediatric patients was observed in several countries, thus leading to many questions about the complex relationship between SARS-CoV-2 infection and T1DM. Our study aimed to highlight possible correlations between SARS-CoV-2 serology and T1DM onset. Therefore, we performed an observational retrospective cohort study that included 158 children diagnosed with T1DM in the period April 2021-April 2022. The presence or absence of SARS-CoV-2 and T1DM-specific antibodies and other laboratory findings were assessed. In the group of patients with positive SARS-CoV-2 serology, a higher percentage had detectable IA-2A antibodies, more children were positive for all three islet autoantibodies determined (GADA, ICA, and IA-2A), and a higher mean HbA1c value was found. No difference existed between the two groups regarding DKA presence and severity. A lower C-peptide level was found in the patients presenting diabetic ketoacidosis (DKA) at T1DM onset. When compared to a group of patients diagnosed before the pandemic, an increased incidence of both DKA and severe DKA, as well as a higher age at diagnosis and higher levels of HbA1c were present in our study group. These findings have important implications for the ongoing monitoring and management of children with T1DM after the COVID-19 pandemic and highlight the need for further research to better understand the complex relationship between SARS-CoV-2 infection and T1DM.
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Affiliation(s)
- Anca Andreea Boboc
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Carmen Nicoleta Novac
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Alexandra Gabriela Marin
- Department of Infectious Diseases, Prof. Dr. Matei Balș National Institute of Infectious Diseases, 021105 Bucharest, Romania
| | - Mara Ioana Ieșanu
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Cristina Plătică
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Teodora Buzescu
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Maria Teodora Coșoreanu
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Felicia Galoș
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
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42
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Kleine R, Galimov A, Hanewinkel R, Unger J, Sussman S, Hansen J. Impact of the COVID-19 pandemic on young people with and without pre-existing mental health problems. Sci Rep 2023; 13:6111. [PMID: 37059814 PMCID: PMC10103038 DOI: 10.1038/s41598-023-32918-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
The objective was to examine pandemic-related changes in depression and anxiety symptoms in adolescents and young adults in Germany considering pre-existing depression and anxiety problems. In this cross-sectional study, 11,523 adolescents and young adults aged 14-21 years who perceived an impact of the Coronavirus disease (COVID-19) pandemic on their mental health reported the frequencies of depression and anxiety symptoms retrospectively for different pre-pandemic and pandemic phases. Data were collected using web-based questionnaires between January 5th and February 20th, 2022. Depression and anxiety were assessed with a modified version of the Patient Health Questionnaire (PHQ-4). Scale-fit cut-offs were used to identify pre-existing elevated depression and anxiety scores. Multilevel mixed linear models were conducted to assess changes in depression and anxiety symptoms from 2019 to 2021 and compare for age, gender and pre-pandemic mental health problems. Among young people who were experiencing mental health changes as a result of the pandemic, the frequency of depression and anxiety symptoms increased during the COVID-19 pandemic. This association was moderated by age, gender, and pre-existing elevated depression/anxiety scores. For young people without elevated pre-pandemic depression/anxiety, the scores increased strongly over time, with 61% reporting elevated depression symptoms and 44% reporting elevated anxiety symptoms in 2021. In contrast, self-perceived change was minimal for adolescents and young adults with elevated pre-pandemic depression and anxiety. Among young people whose mental health has been affected by the COVID-19 pandemic, the group without pre-pandemic mental health conditions reported greater deterioration than those with elevated pre-pandemic depression and anxiety scores. Thus, adolescents and young adults without pre-existing depression and anxiety problems who perceived a change in general mental health due to the pandemic reported an alarming increase in symptoms of depression and anxiety during the COVID-19 pandemic period.
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Affiliation(s)
- Ronja Kleine
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114, Kiel, Germany.
| | - Artur Galimov
- Keck School of Medicine, University of Southern California, 1845 N. Soto Street, Los Angeles, CA, 90033, USA
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114, Kiel, Germany
| | - Jennifer Unger
- Keck School of Medicine, University of Southern California, 1845 N. Soto Street, Los Angeles, CA, 90033, USA
| | - Steve Sussman
- Keck School of Medicine, University of Southern California, 1845 N. Soto Street, Los Angeles, CA, 90033, USA
| | - Julia Hansen
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114, Kiel, Germany
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White AG, Nuzzi LC, McNamara CT, Nussbaum LS, Cappitelli AT, DiVasta AD, Labow BI. Mental Health Conditions and Health-related Quality of Life Changes after Reduction Mammaplasty in Younger Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4902. [PMID: 37020983 PMCID: PMC10069838 DOI: 10.1097/gox.0000000000004902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 04/05/2023]
Abstract
Reduction mammaplasty is increasingly common in younger patients with macromastia. Unfortunately, a recent surge in mental health disorders has been documented in this population. It is unknown how mental health disorders affect patients undergoing reduction mammaplasty. This study examines the impact of concurrent mental health conditions on health-related quality of life outcomes after reduction mammaplasty.
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Affiliation(s)
- Ava G. White
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Laura C. Nuzzi
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Catherine T. McNamara
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Lisa S. Nussbaum
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Alex T. Cappitelli
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Amy D. DiVasta
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
| | - Brian I. Labow
- From the Adolescent Breast Center, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
- Department of Plastic and Oral Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Mass
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Coleman E, Rice M, Smith TS. Addressing Anxiety in Primary Care With Cognitive Behavioral Therapy. J Nurse Pract 2023. [DOI: 10.1016/j.nurpra.2023.104583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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45
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Takács J, Katona ZB, Ihász F. A large sample cross-sectional study on mental health challenges among adolescents and young adults during the COVID-19 pandemic at-risk group for loneliness and hopelessness during the COVID-19 pandemic. J Affect Disord 2023; 325:770-777. [PMID: 36681303 PMCID: PMC9847220 DOI: 10.1016/j.jad.2023.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND The COVID-19 pandemic has posed unprecedented challenges for societies. Emerging data have indicated that the younger population are the most vulnerable group to the development of mental health problems during this pandemic. The present study aimed to examine the effects of the changes in health behaviors on mental health problems to identify an at-risk group among adolescents and young adults. METHODS In the present cross-sectional study, secondary school students (N = 2556) ages 15-21 years participated in Hungary. A self-report questionnaire was developed to measure the changes in health behaviors. Mental health problems were measured by the Beck Hopelessness Scale and the 20-item UCLA Loneliness Scale. RESULTS A significant proportion of the students showed moderate/severe hopelessness or high loneliness which were more pronounced among adolescent females. An at-risk group was identified among adolescents and young adults. Students who have a lower number of friends, spend less time in front of a screen, and feel lonely often/very often are more likely to have moderate/severe hopelessness with high loneliness. LIMITATIONS All data were collected online, and students completed the questionnaires voluntarily. Cross-sectional, non-preregistered study. CONCLUSIONS Loneliness and hopelessness were prevalent in the young population during the COVID-19 pandemic. The at-risk group of adolescents characterized by moderate/severe hopelessness with high loneliness highlights the need for follow-up mental health to avoid future poor mental and physical health. It is also recommended to develop effective interventions targeted to gender and age, with the promotion of resiliencies and buffers against vulnerabilities of negative life events.
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Affiliation(s)
- Johanna Takács
- Department of Social Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.
| | - Zsolt Bálint Katona
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary,Physical Education and Sports Centre, Széchenyi István University, Győr, Hungary
| | - Ferenc Ihász
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
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SARS-CoV-2 transmission in teenagers and young adults in Fútbol Club Barcelona's Multidisciplinary Sports Training Academy. Eur J Pediatr 2023; 182:2421-2432. [PMID: 36914778 PMCID: PMC10010953 DOI: 10.1007/s00431-023-04880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/16/2023]
Abstract
Most studies, aimed at determining the incidence and transmission of SARS-CoV-2 in children and teenagers, have been developed in school settings. Our study conducted surveillance and inferred attack rates focusing on the practice of sports. Prospective and observational study of those attending the sports facilities of Fútbol Club Barcelona (FCB), in Barcelona, Spain, throughout the 2020-2021 season. Participants were young players (from five different sports) and adult workers, who belonged to stable teams (shared routines and were involved in same quarantine rules). Biweekly health questionnaires and SARS-CoV-2 screening were conducted. From the 234 participants included, 70 (30%) both lived and trained in the FCB facilities (Recruitment Pathway 1;RP1) and 164 (70%) lived at their own household and just came to the facilities to train (RP2). During the study, 38 positive cases were identified; none had severe symptoms or needed hospitalization. The overall weekly incidence in the cohorts did not differ compared to the one expected in the community, except for 2 weeks when an outbreak occurred. The attack rate (AR) was three times higher for the participants from RP1, in comparison to those from RP2 (p < 0.01). A Basketball team showed a significant higher AR. Conclusion: Physical activities in stable teams are not related to an increased risk of transmission of SARS-CoV-2, since there were the same observed cases than expected in the community. The risk is higher in indoor sports (Basketball vs. Football), and in closed cohort living settings (RP1 vs. RP2). The fulfilment of preventive measures is essential. What is Known: • Despite the low numerical impact caused in paediatric hospitalizations during COVID-19 pandemic, the social impact has been maximum. • The transmission potential in children and teenagers is limited, and it had been widely demonstrated in school settings. What is New: • Group physical activities in children and teenagers are not also related to an increased risk of transmission of SARS-CoV-2, when preventive measures, such as washing hands, and screening protocols are applied. • Routine and semi-professional sports activities seem safe environments to promote during this pandemic.
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47
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Kiviruusu O, Haravuori H, Lindgren M, Therman S, Marttunen M, Suvisaari J, Aalto-Setälä T. Generalized anxiety among Finnish youth from 2013 to 2021-Trend and the impact of COVID-19. J Affect Disord 2023; 330:267-274. [PMID: 36914117 PMCID: PMC10008046 DOI: 10.1016/j.jad.2023.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/04/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend. METHODS Data from the Finnish School Health Promotion study with 750,000 participants aged 13-20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression. RESULTS Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support. LIMITATIONS The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes. CONCLUSIONS Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Olli Kiviruusu
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Henna Haravuori
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maija Lindgren
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sebastian Therman
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mauri Marttunen
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Suvisaari
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Terhi Aalto-Setälä
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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48
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Vázquez López P, Armero Pedreira P, Martínez-Sánchez L, García Cruz JM, Bonetde Luna C, Notario Herrero F, Sánchez Vázquez AR, Rodríguez Hernández PJ, Díez Suárez A. Self-injury and suicidal behavior in children and youth population: Learning from the pandemic. An Pediatr (Barc) 2023; 98:204-212. [PMID: 36842881 DOI: 10.1016/j.anpede.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/28/2022] [Indexed: 02/28/2023] Open
Abstract
INTRODUCTION Suicidal behaviour and self-harm are increasing in children and adolescents. Non-suicidal self-harm are a dysfunctional method of emotional regulation, and it must be distinguished from suicidal behaviours. METHODS Narrative review of the current situation on suicide and self-harm in Spain. Descriptive study of suicidal behaviours in paediatric emergencies. RESULTS Mental health consultations were analysed (March-2019 to March-2020 and March-2020 to March-2021) in a multicentric study of the SEUP (Spanish Society of Pediatric Emergencies), finding a 122 % increase of the diagnosis of "non-accidental drug intoxication" and 56 % of "suicide/suicide attempt/suicidal ideation". In another prospective analysis, 281 attempts were recorded, with the patient profile being: female (90.1 %), 14.8 years old, 34.9 % without previous psychiatric diagnosis; 57.7% with previous suicidal behaviour. The presence of psychiatric disorders, especially depression, and previous attempts, are the best-known risk factors for suicidal behaviour, although other factors are involved (family, personal or social). Pediatricians should be trained to deal with questions about suicide and acquire the skills to conduct an interview with a supportive and empathetic attitude. In Spain, suicide prevention plans are heterogeneous among communities, and there is not a unified national suicide prevention plan. CONCLUSIONS Primary, hospital and mental health care resources for paediatric population should be strengthened to prevent suicidal behaviours. Specific training for school staff, and child and adolescent psychiatry training for paediatricians and nurses are crucial in the prevention of suicide in children and adolescent population.
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Affiliation(s)
| | | | | | | | | | - Félix Notario Herrero
- Unidad de Pediatría-Adolescencia, Clínica HLA Nuestra Señora del Rosario, Albacete, Spain
| | | | - Pedro Javier Rodríguez Hernández
- Hospital de Día Infantil y Juvenil «Diego Matías Guigou y Costa», Servicio de Psiquiatría, Hospital Universitario Ntra. Sra. de Candelaria y Universidad de La Laguna, Tenerife, Spain
| | - Azucena Díez Suárez
- Unidad de Psiquiatría Infantil y Adolescente, Departamento de Psiquiatría y Psicología Médica, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
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49
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Pruccoli J, Biagi C, Andreozzi L, Fetta A, Sacrato L, Tartarini C, Cordelli DM, Lanari M. Clinical and psychopathological profiles of children with somatic symptom disorders in a pediatric emergency unit: an observational study before and during the SARS-CoV-2 pandemic. Eur J Pediatr 2023; 182:1731-1739. [PMID: 36757495 PMCID: PMC9909631 DOI: 10.1007/s00431-023-04850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/10/2023]
Abstract
Somatic symptom disorders (SSDs) are a group of clinical conditions characterized by heterogeneous physical symptoms, not directly supported by a demonstrable organic process. Despite representing a growing problem in the pediatric age, the literature lacks studies assessing the psychopathological and clinical features of subjects with SSD, particularly during the SARS-CoV-2 pandemic. This is a retrospective, observational study, involving two historical cohorts of children admitted to a tertiary referral Italian hospital over the 2 years preceding and following the start of the SARS-CoV-2 pandemic. Demographic, clinical, socio-economical, and psychological variables were investigated. Standardized tests for the developmental age were administered to assess psychopathological variables. Overall rates and trends of accesses for SSD, as compared to the total accesses for any cause at the Pediatric Emergency Room during the same periods, were reported as well. Fifty-one (pre-pandemic, 29; pandemic, 22) children with SSD were enrolled (age, 11.4 ± 2.4 years, F = 66.7%). Subjects in the pandemic historical cohort reported more frequently fever (p < 0.001), headache (p = 0.032), and asthenia (p < 0.001), as well as more chronic conditions in personal and family history, and fewer previous hospital accesses, as compared to the pre-pandemic cohort. Depressed mood and anxious traits were documented in both samples. None of them had an ongoing or a previously reported SARS-CoV-2 infection. During the pandemic, a clinical psychologist was more frequently consulted before the hospital discharge to mental health services, to support the diagnosis. Conclusion: This study showed the significant burden of SSD in children, highlighting the need to implement pediatricians' education to optimize the management of these patients. Children with SSD who accessed during the SARS-CoV-2 pandemic presented specific clinical features. Future studies, conducted on longitudinal and controlled samples, are indicated to further investigate children with these conditions. What is Known: • Somatic symptoms disorders (SSDs) are frequent in the pediatric age, especially in early adolescence. • Evidence remains scarce on the impact of the SARS-CoV-2 pandemic on SSDs in children. What is New: • Children with SSD who accessed during the SARS-CoV-2 pandemic presented specific clinical features. • The implementation of pediatricians' education and a multidisciplinary approach are needed to optimize the management of SSDs.
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Affiliation(s)
- Jacopo Pruccoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy ,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Carlotta Biagi
- Pediatric Emergency Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 40138, Italy.
| | - Laura Andreozzi
- Pediatric Emergency Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 40138 Italy
| | - Anna Fetta
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy ,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Leonardo Sacrato
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy
| | | | - Duccio Maria Cordelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria dell’Età Pediatrica, Bologna, Italy ,Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, 40138 Italy
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50
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Landman B, Cohen A, Khoury E, Trebossen V, Bouchlaghem N, Poncet-Kalifa H, Acquaviva E, Lefebvre A, Delorme R. Emotional and behavioral changes in French children during the COVID-19 pandemic: a retrospective study. Sci Rep 2023; 13:2003. [PMID: 36737512 PMCID: PMC9897150 DOI: 10.1038/s41598-023-29193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
COVID-19 outbreak caused severe disruptions in daily life, partly due to limitations implemented to prevent the spreading. In France, it included school closures during a national lockdown, then a reopening of schools, with access depending on viral status of students and teachers. Those changes had an impact on children's mental health. We conducted an online cross-sectional study using a parental self-administered survey in December 2021 to explore the emotional and behavioral changes (EBC) during this 5th wave (W5) and retrospectively since the first one (W1) in their children and their multidimensionality with principal factor analysis (PCA) and stability analysis. Out of 4552 parent responders, 62.4% (n = 2839) noticed negative EBC during W1 and 54.1% (n = 2462) during W5 of the pandemic. Only 10.0% of the responders noticed negative EBC at W1 but not during the W5. In younger children (3-6 years old) with significant EBC, PCA revealed three main dimensions at W1 and W5: restlessness, depression and anxiety. In older children (7-13 years old), PCA showed partially similar dimensions: depression-suicidality, anxiety and withdrawal. Almost all correlations between dimensions at W1 and W5 were significantly positive. Every EBC was stable across waves, except for one. Recall bias concerning the EBC during W1 and lack of data concerning parental mental health should be taken into account. Our stability analysis found a strong correlation between dimensions at W1 and W5. Our results highlighted the impact of the COVID-19 outbreak on children's mental health and the predictive aspect of its early deterioration.
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Affiliation(s)
- Benjamin Landman
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France.
| | - Alicia Cohen
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France
| | - Elie Khoury
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France
| | - Vincent Trebossen
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France
| | - Nesrine Bouchlaghem
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France
| | - Hélène Poncet-Kalifa
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France
| | - Aline Lefebvre
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France.,CHS Fondation Vallee, Gentilly, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré Hospital, APHP, Paris, France.,Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
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